What To Do After a Concussion: A Guide for Active Adults

Concussion is one of the most common injuries seen in contact sport, particularly rugby union, football, hockey, cycling, and equestrian activities.

Despite increasing awareness, many people still believe concussion is simply a “knock to the head” that resolves with a few days of rest.

Modern concussion research tells us otherwise.

At TA Physiotherapy, we provide concussion rehabilitation for active adults across our clinics in Henley-on-Thames, Crouch End, and Marylebone. Our aim is to help individuals recover safely, manage symptoms effectively, and return confidently to work, exercise, and sport.

What Is a Concussion?

A concussion is a brain injury caused by a direct or indirect force to the head.

Importantly, you do not need to lose consciousness to sustain a concussion.

In rugby union, World Rugby’s concussion guidance highlights that any player showing signs or symptoms of concussion should be immediately removed from play and assessed appropriately. Their message is simple:

“Recognise and Remove.” (World Rugby Passport)

Concussions can occur following:

  • Rugby tackles and collisions
  • Football headers or impacts
  • Falls from bicycles
  • Road traffic accidents
  • Falls at home or work
  • Contact sports injuries

Common Symptoms of Concussion

Symptoms may appear immediately or develop over several hours.

Common symptoms include:

Physical Symptoms

  • Headache
  • Dizziness
  • Nausea
  • Balance problems
  • Light sensitivity
  • Noise sensitivity

Cognitive Symptoms

  • Brain fog
  • Difficulty concentrating
  • Memory problems
  • Slower processing speed

Emotional Symptoms

  • Irritability
  • Anxiety
  • Mood changes

Sleep Disturbances

  • Difficulty falling asleep
  • Excessive fatigue
  • Disturbed sleep patterns

Not everyone experiences the same symptoms, which is why assessment is so important.

The Biggest Mistake People Make

Historically, complete rest was often recommended following concussion.

However, modern concussion management has evolved significantly.

Current guidance from World Rugby and the RFU emphasises structured assessment and a gradual return to activity rather than prolonged inactivity. (World Rugby)

While the first 24-48 hours remain important for symptom monitoring and relative rest, excessive inactivity can sometimes prolong recovery.

The key is finding the right balance.

If In Doubt, Sit Them Out

One of the strongest messages promoted throughout rugby union is:

“If in doubt, sit them out.” (rugby-league.com)

World Rugby, the RFU HEADCASE programme, and multiple national governing bodies all support immediate removal from play if concussion is suspected. (World Rugby Passport)

Continuing to play after a concussion can place an athlete at increased risk of further injury and prolonged recovery.

What Should You Do Immediately After a Concussion?

Step 1: Stop Playing

If concussion is suspected, do not continue participating in sport.

No athlete should return to play on the same day as a suspected concussion. (sportscotland.org.uk)

Step 2: Seek Medical Advice

Even if symptoms improve quickly, assessment by a healthcare professional is recommended.

Step 3: Monitor Symptoms

Watch for:

  • Worsening headache
  • Repeated vomiting
  • Increasing confusion
  • Changes in behaviour
  • Significant drowsiness

If these occur, urgent medical assessment is required.

Step 4: Avoid High-Risk Activities

Avoid:

  • Contact sport
  • Heavy training
  • Activities with risk of another head impact

until appropriate clearance has been obtained.

Why Do Some People Recover Quickly While Others Don’t?

Most people recover within a few weeks.

However, some individuals experience symptoms for longer.

Factors associated with prolonged recovery can include:

  • Previous concussion history
  • Severe initial symptoms
  • Vestibular dysfunction
  • Neck pain
  • Migraine history

This is where specialist concussion rehabilitation can make a significant difference.

How Physiotherapy Can Help Concussion Recovery

Many persistent concussion symptoms are linked to problems involving:

The Vestibular System

The vestibular system helps control balance and spatial awareness.

Following concussion, some people experience:

  • Dizziness
  • Motion sensitivity
  • Balance problems

The Neck

Neck injuries frequently occur alongside concussion.

Symptoms can include:

  • Headaches
  • Neck stiffness
  • Dizziness

Exercise Intolerance

Many individuals struggle with:

  • Increased symptoms during exercise
  • Elevated heart rate responses
  • Reduced fitness

Physiotherapy can help progressively reintroduce activity in a controlled manner.

Concussion Rehabilitation at TA Physiotherapy

Our concussion rehabilitation programmes may include:

  • Vestibular rehabilitation
  • Balance retraining
  • Cervical spine assessment and treatment
  • Exercise tolerance testing
  • Graduated return-to-sport planning
  • Return-to-work guidance

Every rehabilitation plan is individualised based on symptoms, goals, and activity demands.

Returning to Sport Safely

One of the biggest mistakes athletes make is returning too soon.

World Rugby’s Graduated Return to Play process requires a staged progression through activity before returning to full contact sport. (World Rugby)

For community rugby players, the RFU HEADCASE programme provides a structured Graduated Return to Activity and Sport pathway to ensure recovery is complete before returning to competition. (England Rugby)

The goal is not simply symptom resolution.

The goal is safe and confident return to performance.

Expert Concussion Rehabilitation Across TA Physiotherapy

At TA Physiotherapy, we support active adults recovering from concussion across our clinics in:

Whether your concussion occurred playing rugby, football, cycling, or through an accident, our experienced team can help guide your recovery.

If you’re struggling with persistent symptoms or need support returning to sport, work, or exercise, book a Concussion Rehabilitation Assessment today.

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